Midterm outcomes of mechanical versus bioprosthetic valve replacement in middle-aged patients: An Indian scenario

Abstract

Objective: The goal of this study is to evaluate and compare the midterm outcomes of bioprosthetic heart valve replacement in terms of survival, valve-related events, quality of life, and economic aspects of treatment in population age 45 years and above in females and 48 years in males and their comparison with mechanical valve recipients. Materials and Methods: The patient population under age group of 45–60 years is randomly divided into two groups: One receiving bioprosthetic valves and other receiving mechanical valves. Patients were followed up and data are analyzed. Results: The overall 10-year survival was similar in patients receiving bioprosthetic heart valve and mechanical heart valves. The incidence of major bleeding episodes was very high with mechanical valves (mitral valve replacement [MVR] = 14.3% and aortic valve replacement [AVR] =7.2%) as compared to 0.6% and 0.8% with bioprosthetic MVR and AVR, respectively. About 1.02% of patients with tissue valves have episodes of thromboembolism versus 8.3% patients with mechanical valves. Acute valve thrombosis rates were high in mechanical valve (3.1% vs. 0.0%). Incidences of endocarditis were also more with mechanical valve replacement group (2.3% vs. 0.3%). The quality of life was also better in patients with bioprosthetic valves. Conclusions: Bioprosthetic heart valves seem to be more beneficial in the Indian scenario as compared to mechanical valves because of low incidence of mortality and valve-related events and better quality of life.